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Precocious puberty due to rathke cleft cyst in a child
Shrikrishna V Acharya1, Raju A Gopal, Padma S Menon
1Department of Endocrinology, King Edward VII Memorial Hospital, Mumbai, India.
Objective:
To report a case of a child with precocious puberty attributable to Rathke cleft cyst (RCC).
Methods:
The clinical features, laboratory results, and findings on ultrasonography of the pelvis and magnetic resonance imaging of the pituitary gland are presented.
Results:
A 16-month-old child had breast enlargement, height increase, and an increase in growth velocity. On examination, she was found to have Tanner stage 3 breast development, and her vaginal mucosa was estrogenized. Her height was above the 97th percentile. Biochemically, she was diagnosed as having central precocious puberty, and magnetic resonance imaging of her pituitary gland disclosed RCC. Treatment with leuprolide resulted in normalization of her growth rate and regression of the breast development; the vaginal mucosa also became unestrogenized.
Conclusion:
Although RCC is a relatively common finding, it is a rare cause of precocious puberty. Magnetic resonance imaging of the pituitary gland should be performed in all children younger than 6 years of age who have precocious puberty, in an effort to detect any organic lesions.
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